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In this paper, a novel special structure derived from the double-slider mechanism is presented and apply it to the design of a parallel mechanism, endowing the designed parallel mechanism with reconfigurable characteristics. First, a comprehensive analysis of the motion modes of the double-slider mechanism is carried out. By ingeniously varying the slider structure of the double-slider mechanism, a special structure capable of three distinct motion modes is obtained. This special structure is then integrated into the 3UPU parallel mechanism. As a result, the redesigned 3UPU parallel mechanism exhibits reconfigurability and can seamlessly switch among the three motion modes. Subsequently, the inverse kinematics, workspace, and singular pose of the parallel mechanism in these three modes are meticulously analyzed. Moreover, the Jacobian matrix is utilized to evaluate its flexibility and load-bearing performance. The analysis reveals that in different motion modes, all performance indicators of the mechanism are remarkable, indicating a promising application prospect. Finally, a prototype is fabricated using 3D printing technology to further validate the effectiveness of the proposed special structure. Additionally, its versatility is further explored and analyzed in-depth.
This study aimed to assess the concordance between different anthropometric indexes in the Global Leaders Initiated Malnutrition Standards (GLIM) and the Geriatric Risk Index (GNRI) for evaluating muscle mass, while also exploring performance-based criteria for GLIM muscle content suitable for elderly patients with intermediate and advanced tumors. A total of 312 patients admitted to Shanghai Tenth People’s Hospital between September 2022 and June 2023 were retrospectively included. Nutritional assessments were conducted using the GLIM framework, employing grip strength, upper arm circumference, and calf circumference as criteria for muscle content evaluation. The diagnostic value of these tools was compared against the GNRI as a reference standard. Among the participants, 127 (40.71%) were diagnosed as malnourished by GNRI, while the GLIM assessments yielded 138 (44.23%), 128 (41.03%), and 162 (51.92%) malnutrition diagnoses based on grip strength, calf circumference, and upper arm circumference, respectively. Both GNRI and GLIM-grip strength were significantly associated with complications and length of hospital stays. Notably, using GNRI as a reference, GLIM-grip strength demonstrated good consistency in diagnosing malnutrition (K value = 0.692, P < 0.001), with calf circumference having the highest diagnostic value. In conclusion, grip strength is a practical and effective performance-based criterion within the GLIM standards and has the potential to enhance malnutrition diagnosis in elderly patients with advanced malignancies, highlighting its relevance in nutritional science.
Stimulated Raman scattering is a third-order nonlinear optical effect that is not only effective for wavelength converting laser output, but also for single longitudinal-mode output due to the absence of spatial hole burning. Diamond is a prominent Raman-active medium that has significant potential for linewidth narrowing and wavelength converting lasers at high power levels due to its high thermal conductivity, long Raman frequency shift and wide spectral transmission range. In this work we utilize diamond in a resonantly mode-matched external cavity to achieve cascaded Raman conversion of a 1064 nm laser. By fine-tuning the length of this external cavity, we can obtain narrow linewidth emission at 1240 and 1485 nm. When operating at maximum power, the measured linewidths were more than twofold narrower than the linewidth of the fundamental field. In addition, the noise levels of the Stokes fields are lower than that of the fundamental field throughout the entire noise frequency range, and the intrinsic linewidth of the second Stokes field, which is expressed at the hertz level (~3.6 Hz), is decreased by approximately three orders of magnitude compared to that of the pump. This work represents the first measurement and analysis of the linewidth and noise characteristics of cascaded diamond Raman lasers and, significantly, offers a new means by which high-power, narrow linewidth laser output can be produced from wavelength-converted laser systems.
Large-aperture gratings have significant applications in inertial confinement fusion, immersion lithography manufacturing and astronomical observation. Currently, it is challenging and expensive to manufacture sizable monolithic gratings. Therefore, tiled multiple small-aperture gratings are preferred. In this study, the impact of seam phase discontinuity on the modulation of the laser beam field was explored based on the measurement results of the Shenguang-II laser large-aperture multi-exposure-tiled grating. An innovative method for accurately calculating the phase jump of multi-exposure-tiled grating seams was proposed. An intensive electromagnetic field analysis was performed by applying rigorous coupled-wave analysis to a reasonably constructed micrometer-level periodic grating seam structure, and the phase jump appearing in millimeter-scale seams of large-aperture tiled gratings was obtained accurately.
This study aimed to evaluate a novel rTMS protocol for treatment-resistant depression (TRD), using an EEG 10–20 system guided dual-target accelerated approach of right lateral orbitofrontal cortex (lOFC) inhibition followed by left dorsolateral prefrontal cortex (dlPFC) excitation, along with comparing 20 Hz dlPFC accelerated TMS v. sham.
Methods
Seventy five patients participated in this trial consisting of 20 sessions over 5 consecutive days comparing dual-site (cTBS of right lOFC followed sequentially by 20 Hz rTMS of left dlPFC), active control (sham right lOFC followed by 20 Hz rTMS of left dlPFC) and sham control (sham for both targets). Resting-state fMRI was acquired prior to and following treatment.
Results
Hamilton Rating Scale for Depression (HRSD-24) scores were similarly significantly improved at 4 weeks in both the Dual and Single group relative to Sham. Planned comparisons immediately after treatment highlighted greater HRSD-24 clinical responders (Dual: 47.8% v. Single:18.2% v. Sham:4.3%, χ2 = 13.0, p = 0.002) and in PHQ-9 scores by day 5 in the Dual relative to Sham group. We further showed that accelerated 20 Hz stimulation targeting the left dlPFC (active control) is significantly better than sham at 4 weeks. Dual stimulation decreased lOFC-subcallosal cingulate functional connectivity. Greater baseline lOFC-thalamic connectivity predicted better therapeutic response, while decreased lOFC-thalamic connectivity correlated with better response.
Conclusions
Our novel accelerated dual TMS protocol shows rapid clinically relevant antidepressant efficacy which may be related to state-modulation. This study has implications for community-based accessible TMS without neuronavigation and rapid onset targeting suicidal ideation and accelerated discharge from hospital.
Persistent cognitive deficits and functional impairments are associated with bipolar disorder (BD), even during the euthymic phase. The dysfunction of default mode network (DMN) is critical for self-referential and emotional mental processes and is implicated in BD. The current study aims to explore the balance of excitatory and inhibitory neurotransmitters, i.e. glutamate and γ-aminobutyric acid (GABA), in hubs of the DMN during the euthymic patients with BD (euBD).
Method
Thirty-four euBD and 55 healthy controls (HC) were recruited to the study. Using proton magnetic resonance spectroscopy (1H-MRS), glutamate (with PRESS sequence) and GABA levels (with MEGAPRESS sequence) were measured in the medial prefrontal cortex/anterior cingulate cortex (mPFC/ACC) and the posterior cingulate gyrus (PCC). Measured concentrations of excitatory glutamate/glutamine (Glx) and inhibitory GABA were used to calculate the excitatory/inhibitory (E/I) ratio. Executive and attentional functions were respectively assessed using the Wisconsin card-sorting test and continuous performance test.
Results
euBD performed worse on attentional function than controls (p = 0.001). Compared to controls, euBD had higher E/I ratios in the PCC (p = 0.023), mainly driven by a higher Glx level in the PCC of euBD (p = 0.002). Only in the BD group, a marginally significant negative association between the mPFC E/I ratio (Glx/GABA) and executive function was observed (p = 0.068).
Conclusions
Disturbed E/I balance, particularly elevated Glx/GABA ratio in PCC is observed in euBD. The E/I balance in hubs of DMN may serve as potential biomarkers for euBD, which may also contribute to their poorer executive function.
Large-scale mass-sporting events pose unique challenges for emergency health teams. Data is limited in athletes with sudden cardiac arrests (SCAs) and the emergency medical services (EMS) in major sporting events that took place after the coronavirus pandemic.
Method:
This retrospective observational study describes data from the Taipei Marathon event that took place on December 19, 2021, in Taiwan. The temperature was about 15.2–19.3°C. Four SCAs among 18,144 half-marathoners and the EMS were enrolled.
A medical command center was set up 100 meters from the finish line. Ten medical tents, one first-aid station, and nine event ambulances were distributed along the course, and one medical tent was placed near the baggage storage area. Each medical tent comprised: 1 doctor, 1–3 nurses, and 1–3 paramedics. The in-event EMS also comprised a mobile first-aid team. Thirty paramedics rode motorcycles and carried automated external defibrillators and emergency medical kits throughout the racecourse.
Results:
Among the 7,811 full- and 18,144 half-marathoners, the total number of SCAs was four male half-marathoners. Three runners (75%) stated that they decreased their weekly running volume during the pandemic restrictions’ period. Two runners (50%) experienced cardiac arrest in the final quarter of the race. The median interval of time between SCA occurrence and EMS arrival was 2.5 minutes (interquartile range, 0.5–4 minutes). Electric shocks were delivered to all the four runners (100%) experiencing ventricular fibrillation, and all of them were successfully resuscitated in the field. The median interval of cardiopulmonary resuscitation duration before return of spontaneous circulation was 8.5 minutes (interquartile range, 6–9.5 minutes).
Conclusion:
4/18144 is a significantly high number of SCA compared to data from the annual Taipei Half-Marathon between 2016 and 2020 and past half-marathons worldwide. The high prevalence rate of SCA (22 per 100,000) may be due to inadequate acclimation and training volumes.
Preschooler inactivity and insufficient motor development have serious long-term consequences. The Chinese Ministry of Education launched a nationwide football-focused pilot project aimed at kindergartens in 2019 and issued the policy “Notice on the Establishment of National Football Kindergartens” in 2020. However, the impact of fundamental movement skills (FMS) interventions on other aspects of child development is unclear.
Aim:
This study will evaluate the effects of ball skills physical education projects on the development of Chinese preschoolers’ physical, motor, cognitive, and social competencies and examine the influencing factors.
Method:
This is a quasi-experimental study evaluating how well the “Hello Sunshine” curriculum project promotes children’s development over 10 weeks. The trial will be conducted from September 2021 to November 2021 in 12 classes from 3 kindergartens with a total of 249 children aged 4 to 6 years in Haikou, China. Pre- and posttest analyses will include tests on participants’ physical fitness, FMS, cognitive self-regulation, and emotional competence. Participants’ background information will be collected through questionnaires answered by parents and teachers. The intervention will focus on game-based basic ball skills.
Findings:
If this intervention provides evidence that these skills improve children’s multidimensional development, it will support the promotion of similar programs in China. We will also outline the social-ecological factors affecting the intervention’s results, providing further information for improving pedagogical methods related to preschool ball skills.
The Harihada–Chegendalai ophiolitic mélange, which is located between the Bainaimiao arc and the North China Craton, holds significant clues regarding the tectonic setting of the southern margin of the Central Asian Orogenic Belt. The ophiolitic mélange is mainly composed of gabbroic and serpentinized ultramafic rocks. Here, zircon U–Pb dating, in situ zircon Hf isotopic, whole-rock geochemical and in situ mineral chemical data from the ophiolitic mélange are reported. The zircons in the gabbroic rocks yielded concordia U–Pb ages of 450–448 Ma and exhibited slightly positive ϵHf(t) values (0.87–4.34). The geochemical characteristics of the gabbroic rocks indicate that they were generated from a mantle wedge metasomatized by subduction-derived melts from sediments with continental crust contamination, in a fore-arc tectonic setting. These rocks also experienced the accumulation of plagioclase. The geochemical characteristics of the ultramafic rocks and their Cr-spinels indicate that they may constitute part of residual mantle that has experienced a high degree of partial melting and has interacted with fluids/melts released from the subducted slab in the same fore-arc tectonic setting. The ophiolitic mélange may therefore have formed in this fore-arc tectonic setting, resulting from the northward subduction of the South Bainaimiao Ocean beneath the Bainaimiao arc during Late Ordovician time, prior to the collision between the Bainaimiao arc and the North China Craton during the Silurian to Carboniferous periods.
With the progress in science and technology, hazardous chemicals are becoming more essential in chemical products, industrial and agricultural production, and daily life. Hazardous chemicals have poisoning, corrosive, explosive, and combusting natures; once on fire, they can trigger a chain of catastrophic incidences, resulting in casualties, property loss, and environmental pollution and posing hazards to life and property. Using the “8–12” explosion of the Ruihai Logistics warehouse in Tianjin Port (Binhai New District, China), the present study analyzes the characteristics of trauma of the casualties in this accident and the emergency medical rescue strategies. The goals were to improve the ability of emergency rescue in such accidents and to save people’s lives and property to the maximum extent.
In order to realize the online allocation of collaborative processing resource of smart workshop in the context of cloud manufacturing, a multi-objective optimization model of workshop collaborative resources (MOM-WCR) was proposed. Considering the optimization objectives of processing time, processing cost, product qualification rate, and resource utilization, MOM-WCR was constructed. Based on the time sequence of workshop processing tasks, the workshop collaborative manufacturing resource was integrated in MOM-WCR. Fuzzy analytic hierarchy process (FAHP) was adopted to simplified the multi-objective problem into the single-objective problem. Then, the improved firefly algorithm which integrated the particle swarm algorithm (IFA-PSA) was used to solve MOM-WCR. Finally, a group of connecting rod processing experiments were used to verify the model proposed in this paper. The results show that the model is feasible in the application of workshop-level resource allocation in the context of cloud manufacturing, and the improved firefly algorithm shows good performance in solving the multi-objective resource allocation problem.
Since the outbreak of 2019 novel coronavirus (2019-nCoV) infection in Wuhan City, China, pediatric cases have gradually increased. It is very important to prevent cross-infection in pediatric fever clinics, to identify children with fever in pediatric fever clinics, and to strengthen the management of pediatric fever clinics. According to prevention and control programs, we propose the guidance on the management of pediatric fever clinics during the nCoV pneumonia epidemic period, which outlines in detail how to optimize processes, prevent cross-infection, provide health protection, and prevent disinfection of medical staff. The present consideration statement summarizes current strategies on the pre-diagnosis, triage, diagnosis, treatment, and prevention of 2019-nCoV infection, which provides practical suggestions on strengthening the management of pediatric fever clinics during the nCoV pneumonia epidemic period.
The Wulian complex is located on the northern margin of the Sulu orogenic belt, and was formed by collision between the North China Craton (NCC) to the north and South China Craton (SCC) to the south. It consists of the metasedimentary Wulian Group, gneissic granite and meta-diorite. The U–Pb analyses for the detrital zircons from the Wulian Group exhibit one predominant age population of 2600–2400 Ma with a peak at c. 2.5 Ga and several secondary age populations of > 3000, 3000–2800, 2800–2600, 2200–2000, 1900–1800, 1500–1300 and 1250–950 Ma; some metamorphic zircons have metamorphic ages of c. 2.7, 2.55–2.45, 2.1–2.0 and 1.95–1.80 Ga, which are consistent with magmatic-metamorphic events in the SCC. Additionally, the Wulian Group was intruded by the gneissic granite and meta-diorite at c. 0.76 Ga, attributed to Neoproterozoic syn-rifting bimodal magmatic activity in the SCC and derived from partial melting of Archaean continental crust and depleted mantle, respectively. The Wulian Group therefore has tectonic affinity to the SCC and was mainly sourced from the SCC. The detrital zircons have positive and negative ϵHf(t) values, indicating that their source rocks were derived from reworking of both ancient and juvenile crustal rocks. The major early Precambrian crustal growth took place during c. 3.4–2.5 Ga with a dominant peak at 2.96 Ga and several secondary peaks at 3.27, 2.74 and 2.52 Ga. The two oldest zircons with ages of 3307 and 3347 Ma record the recycling of ancient continental crust (> 3.35 Ga) and crustal growth prior to c. 3.95 Ga in the SCC.
Fertilization in higher plants induces many structural and physiological changes in the fertilized egg, and represents the transition from the haploid female gamete to the diploid zygote, the first cell of a sporophyte. Some changes are induced extremely rapidly following fusion with sperm cells and are the preclusions of egg activation. This review focuses on the early changes that occur in the egg after fusion with sperm cells, but before nuclear fusion. Reported changes include cell shrinkage, cell wall formation, polarity change, oscillation in Ca2+ concentration, and DNA synthesis. In addition, the current understanding of egg activation is summarized and the possible functional relevance of the changes is explored.
This article outlines the evolution of a rescue team in responding to adenovirus prevention with a deployable field hospital. The local governments mobilized a shelter hospital and a rescue team consisting of 59 members to assist with rescue and response efforts after an epidemic outbreak of adenovirus. We describe and evaluate the challenges of preparing for deployment, field hospital maintenance, treatment mode, and primary treatment methods. The field hospital established at the rescue scene consisted of a medical command vehicle, a computed tomography shelter, an X-ray shelter, a special laboratory shelter, an oxygen and electricity supply vehicle, and epidemic prevention and protection equipment. The rescue team comprised paramedics, physicians, X-ray technicians, respiratory therapists, and logistical personnel. In 22 days, more than 3000 patients with suspected adenovirus infection underwent initial examinations. All patients were properly treated, and no deaths occurred. After emergency measures were implemented, the spread of adenovirus was eventually controlled. An emergency involving infectious diseases in less-developed regions demands the rapid development of a field facility with specialized medical personnel when local hospital facilities are either unavailable or unusable. An appropriate and detailed prearranged action plan is important for infectious diseases prevention. (Disaster Med Public Health Preparedness. 2018;12:109–114)
In recent years, with the increasingly frequent variety of large-scale disasters that have happened in China, the Chinese People’s Armed Police Forces (PAP) has undertaken increasingly frequent and diversified tasks, which has led to greater requirements for the construction of emergency medical rescue equipment. Therefore, as determined by the characteristics of the PAP’s tasks and based on the construction of special boxes and frame tent equipment, a new PAP mobile rescue hospital system was successfully developed, and all PAP provincial-level medical rescue teams have been equipped with this system. In the present article, we describe this mobile rescue hospital system, which is mainly composed of professional emergency vehicles, frame-type tents, and advanced medical equipment. The system has the following characteristics: significant integration, a fast response, flexibility, and practicability. The mobile rescue system is generally used as the army’s own health service support system and to provide certain emergency medical rescue services to disaster-stricken people. The successful construction and further application of this system have significance in terms of accelerating the response of rescue teams and the emergency treatment ability of the PAP’s provincial-level emergency medical rescue teams. (Disaster Med Public Health Preparedness. 2018;12:455–459)
Human adenovirus type 55 (HAdV-55) has recently caused multiple outbreaks. This study examined polymorphisms in CD46 to determine their involvement in HAdV-55 infection.
Methods
A total of 214 study subjects infected with HAdV-55 were included in our study. The study subjects were divided into those with silent infections (n=91), minor infections (n=85), and severe infections (n=38). Ten single nucleotide polymorphisms (SNPs) from CD46 were examined.
Results
Compared with the AA genotype, the TT genotype at rs2724385 (CD46, A/T) was associated with a protective effect against disease occurrence, with an odds ratio (95% confidence interval) of 0.20 (0.04-0.97) (P=0.038). There were no significant differences between the patients with minor and severe infection and those who had silent HAdV-55 infection in the other CD46 SNPs. We next compared the polymorphisms of these genes according to disease severity in HAdV-55-infected patients with clinical symptoms. The results showed that there were no significant differences between minor infections and severe infections.
Conclusions
Our results suggested that the CD46 SNP at rs2724385 is associated with the occurrence of disease in HAdV-55-infected patients. A much larger number of samples is required to understand the role of CD46 polymorphisms in the occurrence and progression of infection by HAdV-55. (Disaster Med Public Health Preparedness. 2018;12:427–430)
To explore the 3-tiered treatment model for medical treatment after an earthquake.
Methods
Based on the practices of the national emergency medical rescue services in the Lushan earthquake zone, the 3-tiered treatment classification approach was retrospectively reviewed.
Results
Medical rescue teams assembled and reported quickly to the disaster areas after the earthquake. The number of injured people had reached 25,176 as of April 30; of these, 18,611 people were treated as outpatients, 6565 were hospitalized, and 977 were seriously or severely injured.
Conclusions
The 3-tiered treatment model was the main approach used by rescue services after the Lushan earthquake. Primary and secondary treatments were of the highest importance and formed the basis of the Lushan model of earthquake rescue and treatment. (Disaster Med Public Health Preparedness. 2018; 12: 301–304)
Disaster can strike people in any community at any time anywhere in the world. Disasters occur with high frequency, take on multiple forms, and exert wide influence, typically causing property damage, injuries, and death. As the world’s largest developing country, China incurs great costs when a disaster hits. After the Wenchuan earthquake in 2008, the Chinese government focused its attention on the construction of an emergency response system, the creation of disaster prevention and mitigation systems, and the development of a disaster medicine program. Here, we describe the current status of disaster medicine in China, focusing on the following four aspects: the Emergency Management System, Education & Training, Rescue Practices, and Research. We also discuss the future of disaster medicine in China. (Disaster Med Public Health Preparedness. 2018;12:157–165)
To retrospectively analyze the rescue and treatment of pediatric patients by the Chinese Red Cross medical team during the Nepal earthquake relief.
Methods
The medical team set up a field hospital; the pediatric clinic consisted of 1 pediatrician and several nurses. Children younger than 18 years old were placed in the pediatric clinic for injury examination and treatment.
Results
During the 7-day period of medical assistance (the second to third week after the earthquake), a total of 108 pediatric patients were diagnosed and treated, accounting for 2.8% of the total patients. The earthquake-related injuries mainly required surgical dressing and debridement. No severe limb fractures or traumatic brain injuries were found. Infection of the respiratory tract, the gastrointestinal tract, and the skin were the most common ailments, accounting for 42.3%, 18.5%, and 16.7%, respectively, of the total treated patients.
Conclusion
Two to 3 weeks after the earthquake, the admitted pediatric patients mainly displayed respiratory and gastrointestinal infections. When developing a rescue plan and arranging medical resources, we should consider the necessity of treating non–disaster-related conditions. (Disaster Med Public Health Preparedness. 2016;page 1 of 4)